Author(s)

Giuliana Galli Carminati^1,2, Federico Carminati², Gregory Zecca^3,4

¹Bundang Hospital, Seoul National University, Seoul, Republic of Korea.
²International Society of Multidisciplinary Psychoanalysis, Geneva, Switzerland.
³Cognitive and Affective Regulation Laboratory (CARLA), Institute of Psychology, University of Lausanne, Lausanne, Switzerland.
⁴Research Center in Vocational Psychology and Career Counseling (CePCO), University of Lausanne, Lausanne, Switzerland.

Background: In this paper, we discuss the presence and implications of a triple diagnosis problem (TDP) for patients with Asperger’s syndrome, obsessive-compulsive disorder (OCD), and attention deficit and hyperactivity disorder (ADHD) comorbidity. Purpose: The primary purpose of this paper is to offer a clinical and therapeutical perspective of the Triple Diagnosis Problem due to the frequent comorbidity of the three syndromes. The objective is to help therapists to care for this population. Methods: After a review of the available literature on the subject, we discuss our clinical experience on a limited number of cases. We then describe the psychodynamic context of these syndromes and the feedback loop we have observed in our clinical practice. Then, we present this disorder’s personal, familial, and societal effects. Results: Based on our observations, instead of focusing on the differential diagnosis problem, we propose considering the three syndromes as the expression of a single major etiological factor. We advance the hypothesis that this factor is an epileptic-like syndrome that causes both the neurodevelopmental disorder and the “mental loop” these patients describe as extremely anxiogenic and paralyzing. Conclusions: We propose therapeutical approaches to this condition, both pharmaceutical and environmental, and further studies that could corroborate or refute our hypothesis.

Attention Deficit and Hyperactivity Syndrome, ADHD, Asperger’s Syndrome, Triple Diagnosis Problem, TDP, Obsessive Compulsive Disorder, OCD, Epileptic Syndrome

Carminati, G. , Carminati, F. and Zecca, G. (2023) Strangled by the Loop: Psychodynamic Perspective in ADHD, OCD and Asperger’s Syndrome (TDP Triple Diagnosis Problem). Psychology, 14, 829-843. doi: 10.4236/psych.2023.145044.